UVA Medical Center announces changes to billing, collections policies

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CHARLOTTESVILLE, Va. (WCAV) — The University of Virginia Medical Center has released several policy updates regarding its billing and collection practices.

These changes are being instituted following a very critical Washington Post article concerning the health system's billing practices and families that have been forced into bankruptcy.

According to a release, the changes will reduce medical bills for low-income patients and people who do not have insurance.

It adds they will also reduce the center's reliance on the legal system for the collection of past due debts, which will allow the health system to focus efforts on repayment plans.

The first change is that patients who do not meet a state-approved asset threshold, which for a family of four is $3,200. Previously, they would get a 20-percent discount. Now, the health system says it will go beyond state reimbursement rules and provide additional relief for such patients.

For patients at or below the federal poverty levels who have less than $50,000 in assets, their bills will be written off entirely. The release says a home, a car and up to 3.99 acres of land are not included in the calculation of the patient's assets.

The second change affects patients who are between 101 and 200 percent of the federal poverty line. The medical center currently uses a sliding scale for billing, which depends on the patient's income. For an individual, 200 percent of the federal poverty line is about $25,000 in annual income, while it is $51,500 for a family of four.

Under the changes announced Friday, patients in this income bracket who have less than $50,000 in assets will also have their bills written off entirely.

The third change impacts people who are between 201 and 300 percent of the federal poverty line, which is about $37,000 for an individual or $77,250 for a family of four. Under current health system policies, 20 percent of charges are written off if the patients are not insured.

Now, the health system says it will write off 60 percent of the charges for patients within this income bracket who have less than $50,000 in assets and are uninsured.

The fourth change is for people who fall between 301 and 400 percent of the federal poverty line, or about $50,000 for an individual and $103,000 for a family of four. The health system currently writes off 20 percent of the charges if the patient does not have insurance.

Moving forward, the health system will write off 50 percent of the charges for people in this income bracket who are not insured and have less than $50,000 in assets.

The next change affects people who do not have insurance and who are over 400 percent of the federal poverty line, for whom the health system currently writes off 20 percent of the charges. Now it will write off 40 percent of the charges.

The release says patients who are below the 400 percent of the poverty line and who do have assets over $50,000 will also have 40 percent of their charges written off.

Finally, the release addresses the health system's collection practices, in which it says it recognizes that lawsuits, property liens and wage garnishments can be more than disruptive.

The release adds the health system would prefer to work out a "reasonable repayment plan" and that it will devote attention to this option for the future.

The health system says it will generally reserve suing someone for cases that involve balances of more than $1,000 for people who earn more than 400 percent of the federal poverty level in annual income.

However, there may be "unusual circumstances" that will affect this policy change, though the release does not explain what those types of circumstances might entail.

The release says all these changes require adjustments to the health system's billing system, so they will not officially go into effect until Jan. 1.

It adds the health system is committed to working with anyone who currently owes money they are struggling to pay. People looking for this kind of assistance can call (434) 980-6110 beginning Monday.

The release says the health system will be looking into additional ways to improve its billing and collection system in the coming months. This includes taking a look at how it treats employees and students and how it prices services.

The health system says it will form a working group of internal and external stakeholders to look at the best practices of other institutions, identify areas where there can be additional improvement, and propose solutions that will work at the UVA Health System and beyond.

The release says all of these changes will be monitored and adjusted as needed.

In conclusion, the release explains that as a medical center associated with a public university, it is the health system's mission to provide excellent care to those who need it, which in practice means it treats a comparatively higher number of people who cannot pay.

However, it is legally required as a state agency to collect money that is owed to the state.

The release calls the changes announced on Friday a first step toward finding a better balance, so that the humane values and compassion that drive medical care will also guide how patients are treated after they leave.

On Thursday, several pending lawsuits the health system had filed against patients were dismissed.